• Title/Summary/Keyword: 식이영양

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Quality Characteristics of Protein-enriched Fermented Milk made with Whey and Soybean Flour (유청과 콩가루를 활용한 단백질 강화발효유의 품질특성)

  • Jo, Jun-Hee;Yang, Hee-Sun;Choi, Yu-Jin;Lee, Sang-Cheon;Choi, Bong-Suk;Park, Tae-Young;Kim, Jin-Kyeong;Huh, Chang-Ki
    • Journal of Dairy Science and Biotechnology
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    • v.32 no.2
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    • pp.121-129
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    • 2014
  • This study was carried out to investigate the quality characteristics of protein enriched fermented milk made with whey and soybean flour. Protein-enriched fermented milk was prepared as follows: Soybean flour was added before fermentation. No synthetic aroma was added. The fermentation starter culture was ABT-4 (Chr. Hansen). Whey protein was added after fermentation. Sensory evaluation indicated that sample containing soybean flour amount of 5% were better than other samples. The pH values and titratable acidities of stored protein-enriched fermented milk and fermented milk, respectively, were not remarkably different. Crude protein was more than 3 times higher in protein-enriched fermented milk (8.77%) than in fermented milk (2.49%). The crude fat content of protein-enriched fermented milk was not remarkably different compared to that of fermented milk. Dietary fiber was more than 2.7 times higher in protein-enriched fermented milk (1.67%) than in fermented milk (0.62%), and the free amino acid content was more than 14 times higher in protein-enriched fermented milk (37.9%) than in fermented milk (2.6%).

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담자균류 ${\beta}$ -글루칸의 특성 및 생산

  • Hong, Eok-Gi
    • Proceedings of the Korean Society of Life Science Conference
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    • 2002.05a
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    • pp.17-22
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    • 2002
  • 지구상에는 수천종의 버섯류가 자생하고 있어 유전자원으로서의 중요성이 지대할 뿐만 아니라 기능성 식품소재 및 각종 약리 활성을 나타내는 신약개발 소재로도 크게 주목을 받고 있다. 이들 버섯은 균사체의 영양대사로 얻어지는 대사산물이 축적된 자실체의 형태로 나타나는데, 최근에 와서 자실체 및 균사체의 추출물이나 균사체 배양물이 체질개선이나 각종 병의 예방과 치료에 효과가 있는 것으로 밝혀져 건강식품이나 의약품으로서의 용도가 크게 증가하고 있는 실정이다. 특히, 담자균이 생산하는 특정 구조를 갖는 다당류는 오래전부터 종래의 화학요법제와는 달리 숙주내의 면역 기능을 부활하여 소위 면역요법제로서의 항암효과를 나타냄이 알려져왔었다. 현재까지 제약 및 의학적인 방법이 질병의 주된 치료방법으로 이용되어 왔지만 최근에 특정식품의 섭취가 만성질환의 발생을 억제 또는 지연시킨다는 연구 보고가 나오면서부터 만성질환의 치료방법으로서 식이요법을 중요하게 생각하게 되었다. 따라서 새로운 식품소재 및 가공식품의 개발을 통한 성인병 등의 각종 질병예방이 국민보건문제 해결에 필수적이다. 현재 일본 등에서는 표고버섯, 구름버섯 및 치마버섯 유래의 다당체 또는 단백다당체인 lentinan, krestin 또는 PS-K, schizophyllan 및 PSP 등이 실용화되어 높은 가격에 판매되고 있다. 국내에서도 야생 구름버섯 자실체로부터 추출한 단백 다당체인 Copolang(광동제약)이 개발되어 PS-K와 유사하게 암의 치료에 병행 사용되고 있고, 또 강력한 항암활성이 보고된 상황버섯의 균사체 추출물인 단백 다당체가 Mesima-Ex FK(한국신약)라는 상품명으로 암의 치료에 병행 사용되고 있는 것으로 알려지고 있다. 담자균류와 아울러 미생물 유래 다당체는 그 구조와 특성에 있어서 매우 다양함을 지니고 있다. 이러한 미생물 유래 다당류의 공업적 생산과 이용에 대한 연구로서는 Leuconostoc mesenteroides가 생산하는 dextran이 혈장증량제로 개발된 이래 Xanthomonas campestris가 생산하는 pullulan, Zoogloea rgmigera가 생산하는zooglan둥이 대표적인 예로 보고되고 있다. 한편, 미생물 유래 다당류는 구성당, 분자량, 화학적 구조 등과 같은 특성의 차이에 의해 많은 종류가 존재하고 있으며, 다양한 물성 및 유화제, 응고제, gel 형성제, 필름 형성제, 흡착제, 안정제, 접착제 등과 같은 용도로 광범위하게 이용되고 있다. 또한 근래에 들어서는 미생물 유래 다당체가 지니는 항암활성이 확인되어 새로운 의약품으로서의 개발 가능성이 기대된다. 그 밖에도 기존에 알려져 있는 식물 및 해조류 유래의 다당체와는 달리, 발효조를 이용한 연속배양에 의해 공업적 대량 생산이 가능하며, 더욱이 생산된 다당체의 분리 및 회수가 용이하다는 이점을 지니고 있다. 최근에 들어서는 유전공학적 기법을이용한 고생산성 변이균주 및 새로운 기능을 지닌 다당체의 개발에 관한 연구가 보고되고 있는 등 고부가가치를 지닌 새로운 바이오 소재로서의 기능 및 용도 개발에 관한 연구가 활발히 진행되고 있다. 이러한 항암 활성을 나타내는 여러 가지 담자균류중 Agaricus blazei로부터 생산되는 다당체는 고형암 이외에 S형 결장암, 난소암, 유방암, 폐암, 간암 등에 효과가 입증되었고, 천연물질에 의한 암 면역요법으로 각광을 받고 있으며, 항암 및 항virus의 완치율과 저지율에서 현재 여러가지 약효가 있는 버섯중에서도 탁원한 효과가 있는 것으로 증명되고 있다. 이들 다당체는 사이토카인을 생산시켜서 T임파구와 B임파구의 항원 특이적인 면역반응을 활성화시키고, 세포장해성 T세포와 활성화 대식세포의 세포장해 기능을 충진시켜서 암세포를 파괴시킨다. 또한 콜로니 자극인자인 사이토카인을 생산시켜서 면역담당세포의 신생을 촉진시키기도 하며, 암의 화학요법과 방사선 요법으로 저하된 백혈구를 회복시키는 역할을 한다. 따라서 최근의 연구동향은 생산된 다당체의 항암활성을 향상시키고자 하여 배양기간중에 interleukin을 의도적으로 첨가하는 경향이 있다. 이러한 항암 활성을 나타내는 담자균체 유래 다당체는 버섯의 기원에 따라 그 형태에 약간의 차이를 나타내기는 하나 그 기본 형태는 ${\beta}-(1,6)-glucosyl$ 분지를 가진 ${\beta}-(1,3)-glucan$이며, 평균 분자량은 50 ${\sim}$ 200만 정도이다. Agaricus blazei의 원산지인 브라질의 피에다데(Piedade) 지방의 환경조건(산지의 습도는 80%, 낮 기온 $35^{\circ)C$, 밤 기온 $20{\sim}25^{\circ}C$로 대단히 높으며, 정기적으로 열대지방 특유의 소나기가 내리는 지역)에서 볼 수 있듯이 Agaricus blazei의 성장 환경은 매우 까다로운 편이며, 날것으로는 보관이 잘 안되기 때문에 그 재배에 큰 어려움이 있다. 또한, 고체배양에 의해 생산된 버섯 자실체로부터 유기용매 및 열수추출 방법으로 다당체를 생산하는 방법은 균일한 형태의 버섯 자실체를 공급받기가 어렵기 때문에 다당체의 생산 수율이 낮고, 많은 노동력이 요구되는 어려움이 있다. 그러나 액체배양에 의한 다당체 생산의 경우는 고체배양에 의한 다당체 생산에 비해 일정한 조건하에서 배양이 가능하다는 장점이 있으며, 항상 균일한 균사체 및 배양액을 얻을 수 있다. 따라서 원하는 유용물질을 쉽게 획득할 수 있는 장점이 있다.

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Effects of Silkworm Powder on Blood Glucose and Lipid Levels in NIDDM(Type II) Patients (인슐린 비의존형(Type II) 당뇨환자에서 누에분말 섭취가 혈당 및 혈중지질농도에 미치는 영향)

  • 조미란;조여원;정성현;류재환
    • Journal of Nutrition and Health
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    • v.31 no.7
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    • pp.1139-1150
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    • 1998
  • The purpose of this study is to investigate the effects of the silkworm powder on blood levels of glucose, Hb Alc, insulin, and lipids. Thirty-one NIDDM patients from Kyung Hee Medical Center were divided into two groups : patients with silkworm powder supplements and drug treatments(Drug diabetes) and patients with silkworm powder supplement only(Non-drug diabetes). For the control group, age-matched subjects were recruited. During the 4 weeks of the experimental period, silkworm powder(500mg/mea1) was given to the subjects right after each meal. Nutritional assessments and dietary education were carried out periodically, and body weight and blood pressure were measured when patients visited the hospital. Overnight fasting and 2-h postprandial blood glucose levels were measured at 2 week intervals. The blood levels of insulin, Hb Alc, and lipids were measured before and after the supplements. The mean ages of the three groups were 56.7-59.6 years old. The height, weight, and BMI did not differ among the groups. The fasting blood glucose levels were 138.1$\pm$22.0mg/dl for the Drug treated diabetes group, 175.0$\pm$32.0mg/dl for the Non-drug diabetes group, and 108. 3$\pm$16.gmg/dl for the control group at the begining of the supplement. After 4-wks of supplements, the blood levels of glucose tended to decrease in all three experimental groups. Before the supplements, the 2-h postprandial blood glucose levels of the Drug diabetes, Non drug diabetes, and control groups were 244.7$\pm$62.6mg/dl, 272.4$\pm$40.1mg/dl, and 147.7$\pm$28.0mg/dl, respectively. After the supplement, the levels were 197.2$\pm$30.gmg/dl, 208.6$\pm$ 56.6mg/dl, and 151.3$\pm$30.3mg/dl, respectively. This shows that silkworm powder tended to lower blood levels by 19.4% and 23.4% in NIDDM patient groups. However, the changes in the blood levels of insulin, Hb Alc, ind lipids were not observed after the supplement. In conclusion, the present study has demonstrated that silkworm powder has a tendency to decrease 2-h postprandial blood glucose levels, but it should be used with caution in controlling the diabetes. (Korean J Nutrition 31(7) 1139-1150, 1998)

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A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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Effects Against Obesity and Diabetes of Red Pepper (Capsicum annuum L.) Fermented with Lactic Acid Bacteria (유산균을 이용한 홍고추의 발효를 통한 항비만과 항당뇨 효과)

  • Lee, Jun-Hyeong;Kim, Byung-Hyuk;Yoon, Yeo-Cho;Kim, Jung-Gyu;Park, Ye-Eun;Park, Hye-Suk;Hwang, ak-Soo;Kwun, In-Sook;Kwon, Gi-Seok;Lee, Jung-Bok
    • Journal of Life Science
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    • v.29 no.3
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    • pp.354-361
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    • 2019
  • The red pepper (Capsicum annuum L.) is one of the most important vegetables in traditional Korean food, containing vitamins A, C, and E, polyphenol, and flavonoids. In addition, red peppers have high anti-oxidant ability and are known to be effective in preventing obesity, diabetes, hypertension, digestive disorders, stress, and aging. In this study, we investigated the effects against obesity and diabetes of both fermented and non-fermented red pepper. C57BL/6N mice with induced obesity from an eight-week 45% high fat diet (HFD) were then fed either an HFD or diets containing 2.5% non-fermented red pepper marc (NRM), 1.25% fermented red pepper marc (FRM), or 2.5% FRM for a further eight weeks. An oral glucose tolerance test was performed seven weeks after dietary intake, and body weight, liver, epididymal fat weight, serum insulin level, and HOMA-IR were measured and a lipid content test performed at eight weeks. The results show that the 2.5% FRM diet reduced body and tissue weight, lipid content, serum insulin levels, and HOMA-IR compared to the 2.5% NRM and HFD diets. These results suggest that fermented red pepper is effective against obesity and diabetes. We will use this information as the basic data for the development of health food materials using red pepper.

Quantitative Analysis of Small Intestinal Mucosa Using Morphometry in Cow's Milk-Sensitive Enteropathy (우유 과민성 장병증(cow's milk-sensitive enteropathy)에서 소장 생검조직의 형태학적 계측을 이용한 정량적 분석)

  • Hwang, Jin-Bok;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.45-55
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    • 1998
  • Purpose: To make objective standards of small intestinal mucosal changes in cow's milk-sensitive enteropathy (CMSE) we analyzed histological changes of endoscopic duodenal mucosa biopsy specimens from normal children and patients of CMSE. Methods: We review the medical records of patients who had been admitted and diagnosed as CMSE by means of gastrofiberscopic duodenal mucosal biopsy following cow's milk challenge and withdrawal. Thirteen babies with CMSE, ranging from 14 days to 56 days of age, were studied. Five non-CMSE patients were used as control, ranging from 22 days to 72 days of age. The morphometric parameters under study were villous height, crypt zone depth, ratio of villous height to crypt zone depth, total mucosal thickness and length of surface epithelium by using H & E stained specimens under the drawing apparatus attached microscope. In addition, the numbers of lymphocytes in the epithelium and eosinophil cells in the lamina propria and epithelium were measured. Results: In the duodenal mucosal biopsy specimens in CMSE we found partial and subtotal villous atrophy with an increased number of interepithelial lymphocytes. The mean villous height($135{\pm}59\;{\mu}m$), ratio of villous height to crypt zone depth ($0.46{\pm}0.28$), total mucosal thickness ($499{\pm}56\;{\mu}m$), length of surface epithelium of small intestinal mucosa ($889{\pm}231\;{\mu}m$) in CMSE was significantly decreased compared with the control (p<0.05). The mean crypt zone depth ($311{\pm}65\;{\mu}m$) was significantly greater than the control ($188{\pm}24\;{\mu}m$)(p<0.05). Infiltration of interepithelial lymphocytes ($34.1{\pm}10.5$) were significantly greater than the control ($13.6{\pm}3.6$)(p<0.05). The number of eosinophil cells in both lamina propria and epithelium was no significant differences between groups (p>0.05). The small intestinal mucosa in treated CMSE showed much improved enteropathy of villous height, crypt zone depth, interepithelial lymphocytes compared with the control as well as untreated CMSE. Conclusion: Quantitation of mucosal dimensions confirmed the presence of CMSE. It seems to be a limitation in the capacity of crypt cells to compensate for the loss of villous epithelium in CMSE. Specimens obtained by gastrofiberscopic duodenal mucosal biopsy were suitable for morphometric diagnosis of CMSE. Improvement of CMSE also can be confirmed histologically after the therapy of protein hydrolysate.

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A Study on Dietary Behavior of Chinese Consumers Segmented by Dietary Lifestyle (중국 현지 소비자들의 식생활 라이프스타일 세분화에 따른 식행동 연구)

  • Oh, Ji Eun;Yoon, Hei-Ryeo
    • Journal of the Korean Society of Food Culture
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    • v.32 no.5
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    • pp.383-393
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    • 2017
  • This study was conducted to analyze the dietary lifestyle of local Chinese consumers and to classify dietary characteristics according to their dietary lifestyle factors and dietary behaviors. This investigation was conducted for 1 month from 1 January 2017 targeting 300 adult males and females living in China using the online survey company surveymonkey. Four factors relating to dietary lifestyle were identified, gourmet factor, healthy factor, convenience factor and economic factor, and these were grouped into 4 clusters according to their dietary lifestyle factor scores. Group 1, the gourmet economy group, showed a high percentage of living alone and a high frequency of eating out, but a relatively low percentage of three regular meals per day. Their dietary lifestyle was sensitive to gourmet factors and economic factors, but less sensitive to health and convenience factors. Group 2, the wide interest group, contained a high percentage of individuals in their 30s, as well as more highly educated individuals and a higher income than other groups. Because their dietary lifestyle scores tended to be higher than those of other groups, they sought a variety of new foods and gourmet meals for enjoyment of dining and life, as well as well-being food materials and foods related to health. Group 3, the health economic group, constituted a family-type consumer group with lower income level than the other groups. Members of this group were seeking health food and natural food in their dietary lifestyle and tended to pursue a high economic profit ratio when purchasing food. Finally, group 4 showed a relatively higher percentage of women over 30 and individuals with a college level or higher education than the other groups. This group was more interested in health and taste than price and convenience, and showed the highest LOHAS orientation among middle aged Chinese women. Moreover, members of this group directly utilized their knowledge regarding nutrition in real life.

The Protective Effects of Ethanol Extract of Wild Simulated Ginseng on Carbon Tetrachloride Induced Acute Hepatic Injury in Mouse (사염화탄소 유발 급성 간독성 생쥐모델에서 산양삼 에탄올 추출물의 간 보호 효과)

  • Lee, Soo-Min;Park, Sun-Young;Jang, Gi-Seuk;Ly, Sun-Yung
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.701-710
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    • 2008
  • The wild simulated ginseng (WSG) has been effectively used in folk medicine as a remedy against hepatic disease, hypertension and arthritic disease. However, there is still lack of scientific proof about its antioxidant capability. The present study has been conducted to evaluate the protective role of the WSG ethanol extract in the CCl4-induced oxidative stress and resultant hepatic disfunction in ICR mice. The electron donating abilities and IC50 of WSG etnanol extract were 76.86 ${\pm}$ 1.06% and 33.3 ${\mu}g$/mL (that of ascobic acid was 16.5 ${\mu}g$/mL), respectively. Total antioxidant status of WSG extract was 2.13 ${\pm}$ 0.06 mmoL/mg, while the values of ascorbic acid and BHT were 3.63 ${\pm}$ 0.06 and 3.12 ${\pm}$ 0.02, respectively. ICR mice (aged 3weeks) were fed for 4 weeks on AIN-93M diet and had free access to food and water. The animals were divided into three groups: normal group (intraperitoneally (i.p) injected with PBS at 100 ${\mu}L$/mouse), group C; CCl4-induced and without any treatment. (i.p injected only PBS, 100 ${\mu}L$ /mice), group G; CCl4-induced and treated with WSG (i.p injected with 5 mg WSG extract per mouse, suspended in 100 ${\mu}L$ phosphate buffer). After the i.p. injection of WSG or PBS (5 times for 7weeks), all mice were administered CCl4 in olive oil at the last day of the experiment, except for normal group. The normal group was administered only olive oil. Determination of plasma triglyceride, total cholersterol, fasting glucose and GPT activity was performed using automatic blood analyzer. To evaluate the protective effect against the oxidative stress, DNA fragmentation and TBARS were determined in blood leucocytes and RBC and hepatocyte, respectively. Body and organs weights and food intake did not show significant differences among the groups. Blood total cholesterol of group G was similar to that of normal group, which was the lowest in group C. The fasting blood glucose level was the highest in normal group (205.20 ${\pm}$ 135.24), which were decreased in group C (134.2 ${\pm}$ 79.31) and group G (126.48 ${\pm}$ 77.05). TBARS values in a red blood cell and hepatic tisuue homogenate were lower in group G comparing to the group C. DNA% in tail, tail length (TL) and tail moment (TM) of blood leucoocytes showed the highest values in group C (20.11 ${\pm}$ 2.47, 17.36 ${\pm}$ 2.58, 94.11 ${\pm}$ 12.29) and they were significantly diminished in group G (9.63 ${\pm}$ 1.19, 7.04 ${\pm}$ 1.50, 38.64 ${\pm}$ 7.60). In conclusion, wild simulated ginseng might be a protective agent against the oxidative stress.

Analysis of Korean Dietary Patterns using Food Intake Data - Focusing on Kimchi and Alcoholic Beverages (식품섭취량을 활용한 우리나라 식이 패턴 분석 - 김치류 및 주류 중심으로)

  • Kim, Soo-Hwaun;Choi, Jang-Duck;Kim, Sheen-Hee;Lee, Joon-Goo;Kwon, Yu-Jihn;Shin, Choonshik;Shin, Min-Su;Chun, So-Young;Kang, Gil-Jin
    • Journal of Food Hygiene and Safety
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    • v.34 no.3
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    • pp.251-262
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    • 2019
  • In this study, we analyzed Korean dietary habits with food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Centers for Disease Control and Prevention and we proposed a set of management guidelines for future Korean dietary habits. A total of 839 food items (1,419 foods) were analyzed according to the food catagories in "Food Code", which is the representative food classification system in Korea. The average total daily food intake was 1,585.77 g/day, with raw and processed foods accounting for 858.96 g/day and 726.81 g/day, respectively. Cereal grains contributed to the highest proportion of the food intake. Over 90% of subjects consumed cereal grains (99.09%) and root and tuber vegetables (95.80%) among the top 15 consumed food groups. According to the analysis by item, rice, Korean cabbage kimchi, apple, radish, egg, chili pepper, onion, wheat, soybean curds, potato, cucumber and pork were major (at least 1% of the average daily intake, 158.6 g/day) and frequently (eaten by more than 25% of subjects, 5,168 persons) consumed food items, and Korean spices were at the top of this list. In the case of kimchi, the proportion of intake of Korean cabbage kimchi (64.89 g/day) was the highest. In the case of alcoholic beverages, intake was highest by order of beer (63.53 g/day), soju (39.11 g/day) and makgeolli (19.70 g/day), and intake frequency was high in order of soju (11.3%), beer (7.2%), and sake (6.6%). Analysis results by seasonal intake trends showed that cereal grains have steadily decreased and beverages have slightly risen. In the case of alcoholic beverage consumption frequency, some kinds of makgeolli, wine, sake, and black raspberry wine have decreased gradually year by year. The consumption trend for kimchi has been gradually decreasing as well.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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